| NPI | 1669463774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD417333) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 002294) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2011-02-02 |