| NPI | 1841603834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 290732) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-02338) |
| 207R00000X Internal Medicine (Licence: MA 259406) | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2021-03-16 |