| NPI | 1811283740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 34289) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301104447) |
| 207R00000X Internal Medicine (Licence: AL 34289) | |
| 207R00000X Internal Medicine (Licence: PA MT198624) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2018-05-24 |