| NPI | 1033116025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: RI 11045) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI 11045) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2020-08-31 |