| NPI | 1699706358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ND 4549) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 31613) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2011-08-22 |