| NPI | 1295874279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS10555) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 174885) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-10-15 |