| NPI | 1013534999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 340816) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 340816) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 1632) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 340816) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 1632) | |
| 207R00000X Internal Medicine (Licence: WV 1632) | |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2025-12-10 |