| NPI | 1275760886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 271554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 50506) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2020-03-07 |