| NPI | 1033213111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A92753) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 240730) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2021-11-22 |