| NPI | 1235242314 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D60811) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0060811) | 
| Enumeration Date | 2006-08-16 | 
| Last Update Date | 2013-02-12 |