| NPI | 1821087537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2010-00831) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 737) |
| 208000000X Pediatrics (Licence: SC 737) | |
| 207R00000X Internal Medicine (Licence: NC 2010-00831) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2016-12-14 |