| NPI | 1205920626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: DC cs9911160) |
| Additional Taxonomies | 174400000X Specialist (Licence: DC CS9911160) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-01-28 |