| NPI | 1568650919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NH LT4164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD021946E) |
| 207R00000X Internal Medicine (Licence: NY 245005) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 245005) | |
| 207R00000X Internal Medicine (Licence: WV 22970) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 22970) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD021946E) | |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2020-02-03 |