| NPI | 1790279040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A202488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 289492) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 289492) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2025-07-16 |