| NPI | 1659375194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 75-211) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NM 75-211) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2015-06-25 |