| NPI | 1518015288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: CA A33823) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A33823) |
| 207R00000X Internal Medicine (Licence: CA A33823) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2018-04-10 |