| NPI | 1578543716 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 61158)  | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: DC MD 22102)  | 
| Enumeration Date | 2006-01-20 | 
| Last Update Date | 2020-08-19 |