| NPI | 1619049558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 121147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 61907) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2023-01-04 |