| NPI | 1063855013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A148139) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD175887) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2022-05-16 |