| NPI | 1467793273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 264018-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 264018) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2021-03-12 |