| NPI | 1063405736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: TN MD0000028511) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: VA 0101054883) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2014-03-28 |