| NPI | 1164715389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD461154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02182) |
| 207R00000X Internal Medicine (Licence: MA 258231) | |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2022-07-21 |