| NPI | 1770530065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 232725) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA78631) |
| 207R00000X Internal Medicine (Licence: CA A86251) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2012-01-03 |