| NPI | 1891180980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 87778) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 75647) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 8350) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2022-08-11 |