| NPI | 1235255290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101237850) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ND 11374) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301075357) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA 36458) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2018-08-08 |