| NPI | 1982693115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME38048) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0038048) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2017-01-18 |