| NPI | 1164748562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A168744) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 274282) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2020-11-20 |