| NPI | 1801887831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 56060) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 56060) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2010-01-15 |