| NPI | 1801006275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME113233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301084396) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-09-25 |