| NPI | 1356785265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 65570) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP231) |
| 207R00000X Internal Medicine (Licence: KY R3165) | |
| 207R00000X Internal Medicine (Licence: KY KY49494) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 40791) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2025-07-29 |