| NPI | 1013344506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD203514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 306286) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 63518) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2026-05-13 |