| NPI | 1538351499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 245473) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 244024) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2010-07-21 |