| NPI | 1003298373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SD 12729) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7532) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2021-07-07 |