NPI | 1235445859 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 2706941) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A113372) |
Enumeration Date | 2010-08-19 |
Last Update Date | 2022-02-11 |