| NPI | 1922286228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A89541) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A89541) |
| 207R00000X Internal Medicine (Licence: NY 229774) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA A89541) | |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2008-02-08 |