| NPI | 1588042725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 52048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT016391) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2026-07-01 |