| NPI | 1104919323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 240293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 240293) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 240293) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-06-15 |