| NPI | 1023370731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 262611) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 262611) |
| 207R00000X Internal Medicine (Licence: PA MT202306) | |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2019-07-30 |