NPI | 1205369048 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 334043) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME150602) |
Enumeration Date | 2017-04-08 |
Last Update Date | 2025-08-13 |