| NPI | 1992753024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME45390) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0045390) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2014-11-14 |