| NPI | 1235249913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD036308E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA04886000) |
| 207R00000X Internal Medicine (Licence: FL ME92867) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |