| NPI | 1790911592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A155395) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD039800) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2021-11-29 |