| NPI | 1730363912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME 106174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 247067-1) |
| Enumeration Date | 2007-12-23 |
| Last Update Date | 2012-11-21 |