| NPI | 1619139672 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T5172) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AR E-7840) | 
| Enumeration Date | 2008-06-30 | 
| Last Update Date | 2023-02-09 |