| NPI | 1366888505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101260261) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MS 25081) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2026-03-17 |