| NPI | 1629026794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: KY 33677) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY KY33677) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2023-12-08 |