| NPI | 1689821829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 46832) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP01407) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2014-06-11 |