| NPI | 1104860899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA 42082) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA C42082) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2016-09-28 |