| NPI | 1245288026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 225091) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD11868) |
| 207R00000X Internal Medicine (Licence: ME 26186) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-09-07 |