| NPI | 1386211084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2024016625) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 10248) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2025-06-23 |