| NPI | 1821260985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A11463) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 247858) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2010-11-12 |