| NPI | 1972523769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A51070) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A51070) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2026-04-30 |