| NPI | 1497196687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OK 6119) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 3495) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2022-06-06 |