NPI | 1184790669 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 256741) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME83983) |
207Q00000X Family Medicine (Licence: FL ME83983) | |
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 256741) | |
Enumeration Date | 2006-11-28 |
Last Update Date | 2024-07-24 |