| NPI | 1912922386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: TX G5049) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: GA 89017) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-06-08 |