| NPI | 1164628269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me114224) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25ma08876900) |
| 207R00000X Internal Medicine (Licence: NY 259848) | |
| 207R00000X Internal Medicine (Licence: SD 7821) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2022-08-12 |