| NPI | 1922091701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101251663) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 228906) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2016-08-30 |