| NPI | 1942734405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2023011941) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KS 04-47930) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2023-10-03 |