| NPI | 1194800334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 78-105) |
| Additional Taxonomies | 225B00000X Pulmonary Function Technologist (Licence: NM 78105) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2025-11-13 |