| NPI | 1538175823 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301503937) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101037926) | 
| Enumeration Date | 2006-07-31 | 
| Last Update Date | 2021-02-05 |