| NPI | 1588167373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S9705) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA MD-49662) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NM MD2025-0313) | |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2025-07-16 |