| NPI | 1679922751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2022-01225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB10517100) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2024-02-23 |