| NPI | 1932216033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 272820) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 226958) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2024-06-25 |