NPI | 1619230307 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB09647300) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS022983) |
207R00000X Internal Medicine (Licence: MD H0098527) | |
Enumeration Date | 2012-06-19 |
Last Update Date | 2024-01-09 |