| NPI | 1093267858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 0000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.41199) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2021-01-07 |