| NPI | 1881229417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MA061455) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2023-10-30 |