| NPI | 1699169581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD210077) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD22258) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2026-05-15 |