| NPI | 1013072156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE c1-0005652) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 181861) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2011-11-08 |