| NPI | 1639179997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME93158) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL Me93158) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2014-09-23 |