| NPI | 1659834042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101285003) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-01116) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2025-06-03 |