| NPI | 1538199963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: AZ 30307) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 30307) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-05-16 |