| NPI | 1093940843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 250527) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 48367) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2022-04-11 |