| NPI | 1073993267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD61146346) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT208440) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2022-11-09 |