| NPI | 1164527925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ID M4394) |
| Additional Taxonomies | 174400000X Specialist (Licence: ID M4394) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2009-11-04 |