| NPI | 1679905202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301103762) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103762) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2023-11-20 |