| NPI | 1770997462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 2186) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA DO-05616) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2020-06-29 |