| NPI | 1528296787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 148040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 265091) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2020-03-18 |