| NPI | 1619932290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 63018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 20949) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 20949) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2013-10-10 |