| NPI | 1265418024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: UT 178500-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 1785001205) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2019-12-03 |