| NPI | 1063708725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: UT 9047379-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125060088) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2026-04-13 |