| NPI | 1740663871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 297999) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107895) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2024-06-24 |