NPI | 1124568076 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME161155) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT212369) |
Enumeration Date | 2017-02-26 |
Last Update Date | 2023-04-03 |