| NPI | 1225106016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME124954) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 60235686) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2024-03-28 |