| NPI | 1710976592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 15024R) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 15024R) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2012-03-13 |