| NPI | 1427033349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 187301) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD038632E) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2010-06-23 |