| NPI | 1043217797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NM 81-335) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 81335) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2024-04-11 |