| NPI | 1609979509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 241880-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 241880) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-07-05 |