| NPI | 1205911385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 215968) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: NY 215968) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2017-05-02 |