| NPI | 1760420434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G67143) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 155411) |
| 208000000X Pediatrics (Licence: CA G67143) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-01-07 |