| NPI | 1235248899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 15009) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 242866-1) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-06-23 |