| NPI | 1316357841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA 20A17599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R2378) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2021-03-22 |