| NPI | 1902856362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 168487) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 168487) |
| 207R00000X Internal Medicine (Licence: NY 168487) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-09-11 |