| NPI | 1710962907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 49815) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 44475) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2009-07-15 |