| NPI | 1487069712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 302473-01) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 00000000000000000000) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-05-03 |