| NPI | 1184701344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 20864) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 224633) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2026-09-24 |