| NPI | 1508285602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 52368) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101261841) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2022-01-26 |