| NPI | 1104113398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2014022134) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2014022134) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2025-04-11 |