| NPI | 1831123595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 38023) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229945) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-05-13 |