| NPI | 1790210193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A195647) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T9511) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2025-10-14 |