| NPI | 1144487927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me119230) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 262741) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2014-10-30 |