| NPI | 1679034854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 315919) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125074774) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-06-26 |