NPI | 1346301561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 143966) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 143966) |
Enumeration Date | 2006-12-12 |
Last Update Date | 2010-11-30 |