| NPI | 1629606553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A184782) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA PTL153) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A154782) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-05-26 |