NPI | 1427071091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA08665200) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 37393) |
207R00000X Internal Medicine (Licence: PA MD429518) | |
Enumeration Date | 2006-07-25 |
Last Update Date | 2018-05-31 |