| NPI | 1982233185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD61427512) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 110822) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2026-08-04 |