| NPI | 1225522105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: VA 0101271857) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101271857) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2025-09-05 |