| NPI | 1821306994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A138911) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 273304) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2022-12-19 |