| NPI | 1689935231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 313038-01) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 136194) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2023-08-02 |