| NPI | 1487037909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO DR.0069246) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 61142) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2022-09-13 |