NPI | 1134381239 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 298872-01) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL 30908) |
207R00000X Internal Medicine (Licence: KY TP223) | |
Enumeration Date | 2008-06-30 |
Last Update Date | 2022-06-01 |