| NPI | 1689031742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 283891) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 272531) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2023-03-03 |