| NPI | 1457792814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME145944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02891) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2025-01-27 |