| NPI | 1235661711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 90741) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 64250) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 86605) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-09-04 |