| NPI | 1366896912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 291140) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: RI LP04894) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2025-01-22 |