| NPI | 1033191739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 019902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 019902) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2021-03-26 |