| NPI | 1366421984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 19839) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 19839) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2012-07-30 |