| NPI | 1033379649 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME133652) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101254085) | 
| Enumeration Date | 2008-06-17 | 
| Last Update Date | 2019-04-16 |