NPI | 1437187655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 227933-1) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 227933) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2023-07-05 |