| NPI | 1093767899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 47844) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 47844-020) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 47844-20) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-07-21 |