| NPI | 1093162968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 315480) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 23381) |
| 207R00000X Internal Medicine (Licence: OH 35.136966) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2024-07-12 |