| NPI | 1679519516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME158653) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D0064585) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD445533) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2025-06-03 |