| NPI | 1497797013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 105531) |
| Additional Taxonomies | 174400000X Specialist (Licence: NE 23653) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2026-03-02 |