NPI | 1043743255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA10899000) |
Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KS ET00308) |
207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2021049034) | |
Enumeration Date | 2017-04-05 |
Last Update Date | 2022-10-24 |