| NPI | 1952920845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.175507) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 324498) |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2026-06-03 |