| NPI | 1366405649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME120041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 030908) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 030908) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2016-08-18 |