| NPI | 1245465434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: GA 73903) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NY 266042) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2015-07-15 |