| NPI | 1013950138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 155345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD450188) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2017-04-07 |