| NPI | 1255306973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 195964) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 195964) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 195964) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2012-02-01 |