| NPI | 1770717233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX S0934) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-130845) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2019-11-06 |