| NPI | 1528301942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: MA 266855) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 266855) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2019-07-02 |