NPI | 1184924250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 092269-1) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA01995500) |
Enumeration Date | 2010-10-23 |
Last Update Date | 2010-10-23 |