| NPI | 1356839799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 315426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 315426) |
| 208000000X Pediatrics (Licence: NY 315426) | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2025-06-19 |