| NPI | 1801979406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 314234) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 23407) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2022-07-28 |