| NPI | 1346778461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0102208696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04372) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2025-02-26 |