| NPI | 1508245382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 65648) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10054285) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 76755) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2023-09-08 |