| NPI | 1962471292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G36705) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: CA G36705) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2015-12-04 |