| NPI | 1356300701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 158055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 158055) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2008-04-10 |