| NPI | 1376596445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 1203821) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 1203821) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2012-02-14 |