| NPI | 1114553138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2025027602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01090106A) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2025-09-08 |