NPI | 1568499804 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 40574) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 2372981) |
Enumeration Date | 2006-06-26 |
Last Update Date | 2020-05-15 |