| NPI | 1831416940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 329930-01) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101253950) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2025-02-11 |