| NPI | 1356320618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A065585) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 222989) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2007-07-08 |