| NPI | 1073559001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 159518) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NY 159518) |
| 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: NY 159518) | |
| 208VP0000X (Licence: NY 159518) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2020-02-19 |