| NPI | 1467417220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 149546) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 88575) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2007-07-09 |