| NPI | 1962907956 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T9082) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T9082) | 
| Enumeration Date | 2018-03-29 | 
| Last Update Date | 2025-02-05 |