| NPI | 1508333790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 64654) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 202301714) |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2026-06-22 |