| NPI | 1295185189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS21267) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT017188) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL OS21267) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2024-10-17 |