| NPI | 1265696876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 25766) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5844) |
| Enumeration Date | 2008-07-12 |
| Last Update Date | 2018-04-12 |