| NPI | 1629420989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA DO-05968) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R10714) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2022-08-04 |