| NPI | 1568720167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 58769) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL 142430) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2024-05-06 |