| NPI | 1912692740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5151016209) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 5151016209) |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2026-05-18 |