| NPI | 1386296515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 56449) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351045197) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2025-06-11 |