| NPI | 1154702751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 298948) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT209494) |
| 207R00000X Internal Medicine (Licence: PA MD464824) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2022-05-23 |