| NPI | 1407346646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 320788) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD474505) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2023-07-31 |