| NPI | 1619945326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 259692) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C149431) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-09-14 |