| NPI | 1376549923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 230799) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS19678) |
| 207R00000X Internal Medicine (Licence: NJ 25MB08051300) | |
| 207R00000X Internal Medicine (Licence: PA OS013476) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2023-04-09 |