| NPI | 1366653354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A116214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301087977) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2022-08-24 |