| NPI | 1710336342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 34343) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7658) |
| Enumeration Date | 2016-06-04 |
| Last Update Date | 2022-08-03 |