| NPI | 1740541002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NM MD2024-0159) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD472358) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35132500) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 65987) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2024-08-16 |