| NPI | 1174501423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 54763) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 105645) |
| 207R00000X Internal Medicine (Licence: MA 216303) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2020-08-20 |