| NPI | 1215918420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME114215) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PR 10210) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2012-11-06 |