| NPI | 1093211401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 309463) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 1392349) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2022-09-30 |