| NPI | 1154334936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA C54408) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD016833E) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2017-01-19 |