NPI | 1407959976 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC TL31368) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA05486500) |
Enumeration Date | 2006-09-07 |
Last Update Date | 2008-10-31 |