| NPI | 1821316324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 003985) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 5426720) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2012-02-14 |