| NPI | 1063499614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME110790) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MS 08312) |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2012-07-17 |