| NPI | 1760864045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: FL ME157075) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03543) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: TX BP10062616) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2022-10-14 |