| NPI | 1639183718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ME 015930) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 51173-20) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2011-12-02 |