| NPI | 1063944494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: LA 322287) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 322287) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2024-05-30 |