| NPI | 1669831509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-166969) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351045558) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036-166969) | |
| Enumeration Date | 2016-02-21 |
| Last Update Date | 2024-09-03 |