| NPI | 1255329561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX D 9661) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX D 9661) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2007-12-11 |