| NPI | 1578996419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2019017130) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT203127) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2019-08-16 |