| NPI | 1598841462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 30201) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 158754) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2015-06-18 |