| NPI | 1235759440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 72583) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 333024) |
| 207R00000X Internal Medicine (Licence: PA MD486334) | |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2024-10-07 |