| NPI | 1639605454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD61307600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT212480) |
| 207R00000X Internal Medicine (Licence: WA MD61307600) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-09-25 |