| NPI | 1598310161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 023822) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23822) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2023-06-30 |