| NPI | 1396802955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 274746) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD073744L) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2014-05-30 |