| NPI | 1538154158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME148126) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 019877) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 200901737) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2025-01-22 |