| NPI | 1649471319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A124789) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 107745) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME107745) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2021-11-09 |