| NPI | 1073924056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NV DO2226) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1021) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2024-03-18 |