| NPI | 1154597078 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 63428) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 336-077322) | 
| Enumeration Date | 2008-04-30 | 
| Last Update Date | 2016-01-29 |