| NPI | 1346739703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 71366) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S9148) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2023-01-05 |