| NPI | 1174828271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01085877A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-134982) |
| 207R00000X Internal Medicine (Licence: NY 284837) | |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2022-02-14 |