| NPI | 1821367228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2016-01523) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2016-01523) |
| 207R00000X Internal Medicine (Licence: NJ 25ma09010100) | |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2020-10-26 |