| NPI | 1427442409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 62930) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 293395) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2022-07-30 |