| NPI | 1669741120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PR 19932) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 19932) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2019-07-01 |