| NPI | 1235123191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NH 15701) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 9300133) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2012-09-24 |