| NPI | 1285675439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 36912) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 223729) |
| 207R00000X Internal Medicine (Licence: NV 19714) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA07096300) | |
| 207R00000X Internal Medicine (Licence: NM MD2019-0637) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-09-06 |