| NPI | 1295717015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME0061673) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0061678) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2025-01-31 |