| NPI | 1174736623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 188292) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 188292) |
| 208D00000X General Practice (Licence: NY 188292) | |
| 171100000X Acupuncturist (Licence: NY 188292) | |
| 208M00000X Hospitalist (Licence: NY 188292) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-02-18 |