| NPI | 1053306902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 191212-1) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 191212-1) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 191212-1) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2007-09-20 |