| NPI | 1023435757 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA AFE33801)  | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY AFE33801)  | 
| Enumeration Date | 2014-03-19 | 
| Last Update Date | 2014-03-19 |