| NPI | 1184980765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KS 04-42155) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301100656) |
| Enumeration Date | 2012-04-08 |
| Last Update Date | 2023-09-18 |