| NPI | 1497974380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 248087) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.200358) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2024-05-20 |