| NPI | 1063777100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D87592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2012017808) |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2020-02-04 |