| NPI | 1679673131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 253247) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA md00048460) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2009-07-24 |