| NPI | 1760426597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL 115155) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 23545) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2019-02-19 |