NPI | 1568894772 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 318953) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063952) |
207R00000X Internal Medicine (Licence: GA 076511) | |
Enumeration Date | 2013-07-30 |
Last Update Date | 2022-09-22 |