| NPI | 1255860755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 59359) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL41086) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-07-12 |