| NPI | 1518933308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: TX H0897) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H0897) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-05-06 |