| NPI | 1174677462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2018-01166) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D0066760) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD444194) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2021-08-23 |