| NPI | 1053386748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME57024) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0057024) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2007-12-17 |