| NPI | 1871552661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A36257) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A36257) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2011-09-26 |