| NPI | 1922386655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IN 01085414A) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 65329-20) |
| 208D00000X General Practice (Licence: IL 125.059051) | |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2021-06-04 |