| NPI | 1215295373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OK 33785) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10043542) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2018-08-30 |