| NPI | 1114339397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A143547) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A143547) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2023-04-13 |