| NPI | 1104289735 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 38258) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.38258) | 
| Enumeration Date | 2016-03-31 | 
| Last Update Date | 2023-06-30 |