| NPI | 1154640704 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 77980) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A113811) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2015-01012) | |
| Enumeration Date | 2010-05-21 | 
| Last Update Date | 2025-09-17 |