| NPI | 1972899268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101269453) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198533) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 7876) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2020-07-03 |