| NPI | 1134370679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 239641) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME88560) |
| 207R00000X Internal Medicine (Licence: CA C53607) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2019-04-30 |