| NPI | 1144261389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 042-0006942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 217788-1) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-08 |