| NPI | 1831352590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 256013) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OTO12080) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2017-02-06 |