| NPI | 1043440845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A129813) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 004067) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2025-03-05 |