| NPI | 1336206432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 120263) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 120263) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 120263) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |