| NPI | 1245493899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 120840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MAO4711000) |
| 207R00000X Internal Medicine (Licence: CT 046379) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2008-07-03 |