| NPI | 1841302635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A107553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 2499511) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-06-21 |