| NPI | 1548236243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A25831) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: CA A25839) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: CA A25831) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2009-05-20 |