| NPI | 1801392220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A22378) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 310843) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2026-08-24 |