| NPI | 1265404222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 26336) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2003009194) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2017-12-28 |