| NPI | 1497134357 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 44541) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD463776) | 
| Enumeration Date | 2015-05-26 | 
| Last Update Date | 2025-06-04 |