NPI | 1336458322 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE 344878) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD453391) |
207R00000X Internal Medicine (Licence: NY SSN/ITIN deleted) | |
Enumeration Date | 2010-09-24 |
Last Update Date | 2022-01-28 |