| NPI | 1649270539 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX J8974) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AR E0731) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OK 16975) | |
| Enumeration Date | 2005-07-21 | 
| Last Update Date | 2010-05-20 |