| NPI | 1558894030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D98030) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T4364) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MT MED-PHYS-LIC-100152) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2023-08-24 |