| NPI | 1477939304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 302337) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4193) |
| 207R00000X Internal Medicine (Licence: FL OS13556) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2024-05-06 |