| NPI | 1538612403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A177442) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 300165-01) |
| 207R00000X Internal Medicine (Licence: PA MT212183) | |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2024-03-28 |