| NPI | 1457858938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 339277) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX S9994) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-07-01 |