| NPI | 1487854824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD472343) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 245166) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2025-03-04 |