| NPI | 1629410824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: MA 266345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7115) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2016-07-04 |