| NPI | 1548883069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 87441) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE STUDENT) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2026-08-14 |