| NPI | 1992032635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 261594) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 1111111) |
| 207R00000X Internal Medicine (Licence: MD D72397) | |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2022-08-24 |