| NPI | 1861551145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 179500-1) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 040667) |
| 207R00000X Internal Medicine (Licence: CT 40667) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2019-01-10 |