| NPI | 1386904662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR DO188659) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR LL158520) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2018-09-05 |