| NPI | 1376103630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OT019497) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MB11428000) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2025-07-23 |