| NPI | 1720270549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 234539) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 242770) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2011-03-14 |