| NPI | 1326071804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: TN MD18040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD18040) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-10-10 |