| NPI | 1548599269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME125202) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 18531) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2022-01-03 |