| NPI | 1538553433 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX V9045) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5315204924) | 
| 207R00000X Internal Medicine (Licence: MI 4301117436) | |
| Enumeration Date | 2015-03-27 | 
| Last Update Date | 2025-07-07 |