| NPI | 1649351222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: IA 38916) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 23846) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2011-07-11 |