| NPI | 1265485544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 41772) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 41772) |
| 207R00000X Internal Medicine (Licence: NC 200401417) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-02-23 |