| NPI | 1073505046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PR 4209) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 4209) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2010-09-08 |