| NPI | 1053340927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 153879) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 153879-1) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2023-06-29 |