NPI | 1164955779 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: UT 13440883-1205) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-10797) |
Enumeration Date | 2017-04-10 |
Last Update Date | 2024-01-30 |