| NPI | 1932430592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 050951) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 258886) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 256750) | |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2014-06-25 |