| NPI | 1225173727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 205380-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 205380) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2019-12-06 |