| NPI | 1861915563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD480452) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 388) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2024-03-21 |