| NPI | 1740849249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 5101026840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116032603) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2025-03-12 |