| NPI | 1710142039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 30514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 41431) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA 41431) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2018-04-10 |