| NPI | 1811994916 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX E4159) | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX E4159) | 
| Enumeration Date | 2005-07-05 | 
| Last Update Date | 2024-03-19 |