| NPI | 1538456439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME149208) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD452960) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-07-30 |