| NPI | 1770778045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 257591) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M6273) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 257591) | |
| 363A00000X Physician Assistant (Licence: NY 257591) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2023-07-17 |