| NPI | 1124023668 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 020136) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.020136) | 
| 207R00000X Internal Medicine (Licence: LA MD.020136) | |
| Enumeration Date | 2005-06-20 | 
| Last Update Date | 2025-02-12 |