| NPI | 1477573038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 001885) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 64462) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-07-12 |