| NPI | 1538126685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME62191) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 14158) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2021-05-12 |