| NPI | 1831553346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 96083) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-01934) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2024-01-22 |