| NPI | 1720025281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 1575571205) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: UT 1575521205) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2016-09-16 |