| NPI | 1285983601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A143686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 281526) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2016-10-03 |