| NPI | 1205898087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NC 9701149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9701149) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2016-05-23 |