| NPI | 1356406631 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA05988400)  | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA05988400)  | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ MA59884)  | |
| Enumeration Date | 2006-12-27 | 
| Last Update Date | 2022-08-15 |