| NPI | 1619439536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 06051) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 250936) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-06-06 |