| NPI | 1598738536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2019035085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 164855) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2019-10-09 |