| NPI | 1285238113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NY 223195) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 223195) |
| Enumeration Date | 2020-11-22 |
| Last Update Date | 2020-12-29 |