| NPI | 1235486267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 82500) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI L2231647) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2026-06-08 |