| NPI | 1063975530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 103459) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 41731) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2026-01-05 |