NPI | 1255392866 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0066915) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 204857) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2013-05-09 |