| NPI | 1083917140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 307866) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 307866) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 307866) | |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2022-10-18 |