| NPI | 1649266453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: TN MD45651) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: FL ME47581) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2024-07-15 |