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 |