| NPI | 1487821385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 252213-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 240558) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2022-09-02 |