| NPI | 1104810704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 20151) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD020151) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2023-08-23 |