| NPI | 1790053528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A134736) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 263568-1) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2024-05-07 |