| NPI | 1881767879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 145942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 145942) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2008-10-15 |