| NPI | 1992794101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: DC 15876) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D33554) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2007-10-04 |