NPI | 1154332062 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 234979) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD455301) |
207R00000X Internal Medicine (Licence: FL ME 94418) | |
Enumeration Date | 2006-08-10 |
Last Update Date | 2020-05-13 |