| NPI | 1174509186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 21909) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 49412) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2011-02-28 |