| NPI | 1790098655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO DR.0062411) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD449189) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2019-09-10 |