| NPI | 1760801955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX R1639) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 278244) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-06-30 |