| NPI | 1598865081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 227350) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 165696) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2024-03-09 |