NPI | 1104825751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 216969) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C53583) |
2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: NY 216969) | |
Enumeration Date | 2005-07-17 |
Last Update Date | 2024-01-03 |