| NPI | 1104886241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A67079) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A67079) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2019-08-16 |