| NPI | 1407122740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IN 01081272A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC MD40553) |
| 207R00000X Internal Medicine (Licence: GA 75429) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2022-11-15 |