| NPI | 1518428440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 3013904) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS022111) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2026-07-31 |