| NPI | 1659698579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX P3109) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.120755) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2024-01-09 |