| NPI | 1487696910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 044791) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 236890) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2022-07-21 |