| NPI | 1699265587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 65957) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 65957) |
| 207R00000X Internal Medicine (Licence: MN 29598) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX W7627) | |
| 207R00000X Internal Medicine (Licence: TX W7627) | |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2026-09-09 |