| NPI | 1659397883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO R6H93) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO R6H93) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-04-25 |