| NPI | 1972935476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 266219) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7088) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2026-03-27 |