| NPI | 1144498080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 258751) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD44842) |
| 207R00000X Internal Medicine (Licence: TX N7968) | |
| 207R00000X Internal Medicine (Licence: IL 5983681) | |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2013-01-07 |