| NPI | 1467466235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101245481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2006-01167) |
| 207R00000X Internal Medicine (Licence: NJ MA08492700) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2010-03-22 |