| NPI | 1932260551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 232349) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD429147) |
| 207R00000X Internal Medicine (Licence: CT 048921) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2017-09-11 |