| NPI | 1114174513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 257209) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 257209) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: NY 257209) | |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2025-08-24 |