| NPI | 1760448468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 307641) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD055855L) |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2026-05-01 |