NPI | 1083293559 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 33282501) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 169401) |
Enumeration Date | 2021-04-03 |
Last Update Date | 2024-09-27 |