| NPI | 1205275336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX s8671) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 58748) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2021-05-13 |