| NPI | 1053425637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: OH 35.120455) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NJ 25MA05394400) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-07-14 |