| NPI | 1851870620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2023-01530) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-01530) |
| Enumeration Date | 2018-08-12 |
| Last Update Date | 2025-10-11 |