| NPI | 1912904079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX K1260) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K1260) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2011-10-12 |