| NPI | 1952501983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 29469) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 602) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: AL 29469) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2020-06-01 |