| NPI | 1912347980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: RI MD17190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MTL001692) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2020-09-18 |