| NPI | 1093850745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 47130) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 060-0003167) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2013-06-27 |