| NPI | 1568666006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MT MED-PHYS-LIC-18554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-114599) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2021-04-07 |