| NPI | 1619960655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 201103871) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 29345) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2022-09-27 |