| NPI | 1376815647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101284367) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10446900) |
| 207R00000X Internal Medicine (Licence: WI 84972) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA10446900) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA10446900) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 84972) | |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2025-04-02 |