| NPI | 1194389809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A180773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 309778-01) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2024-01-12 |