| NPI | 1710931084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 263978) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: RI MD04629) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2012-01-12 |