| NPI | 1720584519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 5145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT018372) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2026-06-22 |