| NPI | 1538168521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60448523) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NY 127865) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2014-11-07 |