| NPI | 1467898767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 40962) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 40962) |
| 207R00000X Internal Medicine (Licence: NC 2016-01029) | |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2020-06-10 |