| NPI | 1598783706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 163293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME83128) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-05-20 |