| NPI | 1629025069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA MD027769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.022769) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2015-01-20 |