| NPI | 1508962606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX N5020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 41462) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2022-08-09 |