| NPI | 1932599222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 280820) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME127240) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2024-05-28 |