| NPI | 1699182717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: KY 53642) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10422300) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2020-07-23 |