| NPI | 1083695712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: IA 25114) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 25114) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: IA 25114) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2007-11-30 |