| NPI | 1285368167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME173510) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT226789) |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2025-04-29 |