| NPI | 1699955021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2012-00830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125049041) |
| 207R00000X Internal Medicine (Licence: FL ME 100992) | |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2020-10-25 |