| NPI | 1083142509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD482085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 65460) |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2026-07-15 |