| NPI | 1780810697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 253101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301510567) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2024-01-04 |