| NPI | 1316504830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-19668) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 108673) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2025-09-09 |