NPI | 1184915803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 262268) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 270115) |
Enumeration Date | 2011-04-28 |
Last Update Date | 2023-12-22 |