| NPI | 1427132703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 029939) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: NY 159882) |
| 207R00000X Internal Medicine (Licence: NY 159882) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2025-10-13 |