| NPI | 1619060167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 51688) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 36237) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-01-07 |