| NPI | 1346445392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 266260) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: NY 163610) |
| 207R00000X Internal Medicine (Licence: NY 163610) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2018-07-12 |