| NPI | 1780065490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA OS018423) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT016523) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2021-11-23 |