| NPI | 1124656681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 324927) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A185124) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-07-22 |