| NPI | 1962601914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX N3204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD432143) |
| 207R00000X Internal Medicine (Licence: TX N3204) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2023-02-22 |