| NPI | 1134381239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 298872-01) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL 30908) |
| 207R00000X Internal Medicine (Licence: KY TP223) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2022-06-01 |