| NPI | 1275734717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 282099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 018645) |
| 207R00000X Internal Medicine (Licence: MI 4301104920) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2015-11-06 |