| NPI | 1518917608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 283862) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS008854L) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2017-04-12 |