| NPI | 1245494889 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: DC MD038192) | 
| Additional Taxonomies | 174400000X Specialist (Licence: DC MD038192) | 
| 174400000X Specialist (Licence: MD D69440) | |
| Enumeration Date | 2008-07-14 | 
| Last Update Date | 2019-12-10 |