| NPI | 1417182346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.206584) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 267710) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2021-03-08 |