| NPI | 1285909614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2014-0952) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 281966) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2023-06-07 |