| NPI | 1962610360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 203201) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA PGY1) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2021-01-04 |