| NPI | 1942211198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD464010) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 43402) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2019-01-07 |