| NPI | 1275590473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 56301) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 56301) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2015-02-04 |