| NPI | 1972687127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX N5002) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2004015138) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2023-01-18 |