| NPI | 1013076470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL 109689) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 247648) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-07-17 |