| NPI | 1396186466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101274779) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 58778) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2022-07-26 |