| NPI | 1760764872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 313254) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 313254) |
| 207R00000X Internal Medicine (Licence: MA 258679) | |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2025-03-17 |