| NPI | 1861485047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D56953) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: DC MD22067) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2013-12-20 |