| NPI | 1124334859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 000327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N5732) |
| 207R00000X Internal Medicine (Licence: OK 5088) | |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2014-07-31 |