| NPI | 1952614554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A112517) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A112517) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2021-11-02 |