NPI | 1013449354 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY MD.61075325) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD.61075325) |
Enumeration Date | 2017-03-28 |
Last Update Date | 2023-10-08 |