| NPI | 1457305468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036056321) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NV 17408) |
| 2278P1004X Respiratory Therapist, Certified, Pulmonary Diagnostics (Licence: IL 036056321) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2019-08-08 |