| NPI | 1467448050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 156606-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD482302) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2023-11-10 |