| NPI | 1629173414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 230487) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A88838) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2023-02-06 |