| NPI | 1457598088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 268411) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD13102) |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2014-03-06 |