| NPI | 1639526023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036.149652) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.068174) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2019-06-18 |