| NPI | 1467616912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 271044) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.053924) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2017-09-08 |