| NPI | 1992061816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301107106) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 0134) |
| 207R00000X Internal Medicine (Licence: MI 4301107106) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2020-02-14 |