| 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 |