NPI | 1457714321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 19891) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A181749) |
207R00000X Internal Medicine (Licence: NY 303505) | |
Enumeration Date | 2016-03-30 |
Last Update Date | 2023-06-30 |