| NPI | 1801450630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX BP10080159) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL82892) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2022-09-05 |