| NPI | 1427182518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 149040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 14904001) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-06-10 |