| NPI | 1821066986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101027271) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101027271) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2015-10-15 |