| NPI | 1952388845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C161178) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 233307) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2023-12-22 |