| NPI | 1689037665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME156750) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 302250) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2022-09-02 |