| NPI | 1043839251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 4574) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT020296) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2026-07-08 |