| NPI | 1801990478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD10756) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD10756) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2015-01-14 |