| NPI | 1336116037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 153836-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD028026E) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2011-06-22 |