| NPI | 1699776948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 139103) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 49892) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 139103) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 49892) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2010-07-22 |