| NPI | 1861658387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS19787) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 250709) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2026-05-14 |