| NPI | 1174686232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 145170) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 145170) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2014-07-18 |