| NPI | 1578630174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 47262) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 47262) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2016-02-17 |