| NPI | 1760471775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD13071) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD13071) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2007-07-08 |