| NPI | 1902463300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ID 9771231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10067178) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2025-05-24 |