| NPI | 1679648117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G68758) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G68758) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2010-01-27 |