| NPI | 1336568393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: MA 286706) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D85381) |
| 207R00000X Internal Medicine (Licence: MD UMP) | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2021-07-22 |