| NPI | 1164485892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME132544) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101240380) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2018-06-11 |