| NPI | 1215450606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 83630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271565) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2024-07-24 |