| NPI | 1497310031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 317804) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT217289) |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2024-12-07 |