| NPI | 1306229109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 82020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 7554) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101273172) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2023-04-12 |