| NPI | 1255332789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07703500) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA07703500) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 233510) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2021-04-30 |