| NPI | 1437511805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301510885) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 298412) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2024-04-01 |