| NPI | 1053373464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: MI 4301505529) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: PA MD017104E) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2025-05-27 |