NPI | 1184883993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA md439394) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0009410) |
207R00000X Internal Medicine (Licence: NY 307615) | |
Enumeration Date | 2008-06-06 |
Last Update Date | 2025-08-28 |