| NPI | 1194726521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101239816) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 24225) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2026-09-30 |