| NPI | 1972657260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301041569) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: MI LJ041569) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2024-02-14 |