| NPI | 1548258171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA MD040052L) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD040052L) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2011-06-16 |