| NPI | 1194836791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME MD25525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 41337) |
| 207R00000X Internal Medicine (Licence: NH T-0854) | |
| 207R00000X Internal Medicine (Licence: NH 17579) | |
| 207R00000X Internal Medicine (Licence: NY 311267-01) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-04-20 |