| NPI | 1003881038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 153771-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD027605E) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-10-17 |