| NPI | 1205156981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME116105) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TBA) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2016-05-19 |