| NPI | 1104898980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0058957) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: UT 180844-1205) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MT 70035) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2021-03-30 |