| NPI | 1487018750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 62725) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 238716-1) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 60484) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2019-08-14 |