| NPI | 1487002549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 83076) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL os15182) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2022-11-21 |