| NPI | 1568894772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 318953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063952) |
| 207R00000X Internal Medicine (Licence: GA 076511) | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2022-09-22 |