| NPI | 1346570587 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 281888)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036129688)  | 
| Enumeration Date | 2010-01-11 | 
| Last Update Date | 2020-12-15 |