| NPI | 1205948882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 263431) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 002385) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-01-03 |