| NPI | 1356574099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME176538) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08823600) |
| 207R00000X Internal Medicine (Licence: NY 209838-1) | |
| 202K00000X Phlebology (Licence: FL ME176538) | |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2026-03-20 |