| NPI | 1659407716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ID M-7096) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA C-31622) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX D-1757) | |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2007-07-09 |