| NPI | 1639283765 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX E1629) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX E1629) | 
| Enumeration Date | 2006-08-18 | 
| Last Update Date | 2013-06-27 |