| NPI | 1992798003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 186291) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 186291) |
| 225500000X Specialist/Technologist (Licence: NY 186291) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2013-03-20 |