| NPI | 1912053307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 273444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2008016769) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-06-08 |