| NPI | 1992325849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 76332) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01090013A) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-07-16 |