| NPI | 1083856991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 271384) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NY 271384) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2017-04-13 |