| NPI | 1881036838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 318213) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267556) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2023-01-06 |