| NPI | 1619339769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME160252) | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301502792) | 
| Enumeration Date | 2016-03-27 | 
| Last Update Date | 2023-05-25 |