| NPI | 1356467351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101258658) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 238721) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 238721) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2021-06-04 |