| NPI | 1659397537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NH 14143) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: CO DR39862) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2012-03-02 |