| NPI | 1851356356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101237392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 2191461) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2014-03-10 |