NPI | 1376580787 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N9639) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 239632) |
207R00000X Internal Medicine (Licence: PA MD428895) | |
207R00000X Internal Medicine (Licence: NY 239632) | |
207Q00000X Family Medicine (Licence: PA MD428895) | |
Enumeration Date | 2006-06-02 |
Last Update Date | 2016-03-04 |