| NPI | 1144660754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 295780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 63815) |
| 207R00000X Internal Medicine (Licence: MD D87163) | |
| 207R00000X Internal Medicine (Licence: IL 036150346) | |
| 207R00000X Internal Medicine (Licence: MA 272839) | |
| 207R00000X Internal Medicine (Licence: MA 256259) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA10635600) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2024-06-05 |