| NPI | 1316526866 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 79358) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R78617) | 
| Enumeration Date | 2021-04-02 | 
| Last Update Date | 2025-05-16 |