| NPI | 1033597554 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036155287) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4408) | 
| 207R00000X Internal Medicine (Licence: FL OS14254) | |
| Enumeration Date | 2015-05-16 | 
| Last Update Date | 2022-03-24 |