| NPI | 1023014974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 187756-1) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 187756-1) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2017-01-06 |