| NPI | 1972948081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX Q8246) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R728000) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2023-12-08 |