| NPI | 1851359442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2007-01027) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 162805) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2013-02-21 |