| NPI | 1992012173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX P2861) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 246560) | 
| 207R00000X Internal Medicine (Licence: TX P2861) | |
| Enumeration Date | 2010-09-09 | 
| Last Update Date | 2017-10-19 |