| NPI | 1598911547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 264935) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 264935) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 264935) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 264935) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2023-07-22 |