| NPI | 1134258676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 58859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 187202) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2021-07-20 |