| NPI | 1659388494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NY 236923) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 228885) |
| 207Q00000X Family Medicine (Licence: NY 236923) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2016-02-18 |