| NPI | 1326656224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 323794) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL84762) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2023-06-22 |