| NPI | 1265691281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A123901) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 262468) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2022-11-04 |