| NPI | 1699726489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 126227) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NY 126227) |
| 208000000X Pediatrics (Licence: NY 126227) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2008-09-18 |