| NPI | 1285130005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 71087) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 71087) |
| 208000000X Pediatrics (Licence: MN 71087) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-09-16 |