NPI | 1649351214 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 196782) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 196782) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2024-06-18 |