| NPI | 1548557655 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IN 01073912A) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125060011) | 
| Enumeration Date | 2011-07-09 | 
| Last Update Date | 2018-03-17 |