| NPI | 1417045402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 111518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 111518) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2010-06-29 |