| NPI | 1730181231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 114499-01) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 38651) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 38651) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2022-06-15 |