| NPI | 1124516513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 98196) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042.0015975) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2024-05-27 |