| NPI | 1528077666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 155617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 265550) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2020-11-23 |