| NPI | 1326135468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 243841) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 227696) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2010-10-05 |