| NPI | 1790869675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO 0047224) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2000-01430) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-02-25 |