NPI | 1538612403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A177442) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 300165-01) |
207R00000X Internal Medicine (Licence: PA MT212183) | |
Enumeration Date | 2016-07-27 |
Last Update Date | 2024-03-28 |