| NPI | 1386750222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D69842) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 239469) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2021-05-31 |