| NPI | 1568710473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME111476) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME111476) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY TP657) | |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2025-02-28 |