| NPI | 1255392437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 228194) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 228194) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-08 |