| NPI | 1750546362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 278387-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 0008483-1) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2017-05-19 |