| NPI | 1144750704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX U5998) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME145823) |
| 207R00000X Internal Medicine (Licence: PA MT213880) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2023-09-22 |