| NPI | 1568428613 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 43763) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 3587625) | 
| 207R00000X Internal Medicine (Licence: TN 43763) | |
| Enumeration Date | 2006-04-25 | 
| Last Update Date | 2025-05-27 |