| NPI | 1225036981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 000413) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: RI DO00565) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2025-06-23 |