| NPI | 1871773168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: UT 7250922-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-115860) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2009-07-31 |