| NPI | 1548308463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 255870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD425581) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2010-11-23 |