| NPI | 1154528354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 260193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 15676) |
| 207R00000X Internal Medicine (Licence: ME MD19795) | |
| 207R00000X Internal Medicine (Licence: CA A118629) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2024-03-13 |