| NPI | 1942735758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 95368) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT017698) |
| Enumeration Date | 2017-04-30 |
| Last Update Date | 2024-06-04 |