| NPI | 1073802286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME147348) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D80049) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D80049) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2020-11-04 |