| NPI | 1336571116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10976700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.135018) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME134216) | |
| 207R00000X Internal Medicine (Licence: TX U6932) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 75822) | |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2026-06-29 |