| NPI | 1891764692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD016138E) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 238260) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 238260) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2016-02-17 |