| NPI | 1447228325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD23937) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 248055) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2008-05-20 |