| NPI | 1720148612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A88835) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M5308) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-09-15 |