| NPI | 1790747079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 194585) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 194585) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 194585) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2015-12-04 |