| NPI | 1649218983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME132016) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 205455) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2021-09-09 |