| NPI | 1831544022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D96992) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 30779) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 30778) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2023-09-05 |