| NPI | 1265655773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A85765) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A85765) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-02-11 |