| NPI | 1922119411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD07640) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: RI MD07640) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: RI MD07640) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-12-06 |