| NPI | 1316294200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 281409) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01078115A) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2019-10-10 |