| NPI | 1174637110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 40250) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036094737) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036094737) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-12-22 |