| NPI | 1053301325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 44014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 44014) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 44014) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2014-02-11 |