| NPI | 1033352448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS16406) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 263962) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2020-06-30 |