| NPI | 1184646234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 16579) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD22405) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: AL 16579) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2018-09-26 |