| NPI | 1124476379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL OS14948) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4953) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2022-04-20 |