| NPI | 1477316636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 311530) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: NY 311530) |
| 207X00000X Orthopaedic Surgery (Licence: NY 311530) | |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-01-31 |