| NPI | 1881867935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 265348) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125053811) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA MD.203862) | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2021-11-03 |