| NPI | 1891745543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME133145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 39292) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX P3243) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-07-21 |