| NPI | 1912015637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G42320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G42320) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-09-24 |