| NPI | 1104081074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 249426) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 249426) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2024-02-01 |