| NPI | 1134124464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 214341) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A065060) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2022-01-03 |