| NPI | 1528043049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0020094) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D0020094) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2009-11-09 |