NPI | 1306885306 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 186084) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 74604) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2016-06-16 |