NPI | 1417034943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME159614) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A75053) |
207R00000X Internal Medicine (Licence: NY 228064) | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2023-01-04 |