NPI | 1598310161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 023822) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23822) |
Enumeration Date | 2019-08-09 |
Last Update Date | 2023-06-30 |