| NPI | 1417012808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 194607-1) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: NY 19496071) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-04-28 |