| NPI | 1366758518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NY 270597) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198294) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2021-06-03 |