| NPI | 1932385358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 058499) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KS 0435093) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2012-05-09 |