| NPI | 1043232127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2012-01959) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 002624) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2025-02-06 |