| NPI | 1912391822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 292665) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NY 292665) |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2024-01-05 |