| NPI | 1124203054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NV 13889) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125048883) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2022-07-21 |