| NPI | 1902861792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G84651) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: CA G84651) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2008-06-16 |