| NPI | 1457844862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 314078) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020010487) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2024-12-24 |