| NPI | 1376562132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-11709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 240675) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2018-11-07 |