| NPI | 1265516926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO 18368) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 18368) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-07-09 |