| NPI | 1952309841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX P2152) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G42915) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2012-03-13 |