| NPI | 1942689203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 60847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60847) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 20856) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2021-07-13 |