| NPI | 1376861740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 274046) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 53218) |
| 207R00000X Internal Medicine (Licence: CT 52328) | |
| 207R00000X Internal Medicine (Licence: CA 150540) | |
| 207R00000X Internal Medicine (Licence: PA MD481908) | |
| 207R00000X Internal Medicine (Licence: HI 17405) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2024-03-07 |