| NPI | 1114944824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: CA A45841) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A045841) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-03-07 |