| NPI | 1952387300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 19105) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D41786) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 19105) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MO-039584-E) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2024-09-25 |