| NPI | 1598020489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 74937) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2012018714) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX R6581) | |
| Enumeration Date | 2012-07-07 |
| Last Update Date | 2023-09-20 |