| NPI | 1154396109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60720548) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD029256E) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2024-05-31 |