NPI | 1700917952 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C182362) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 207016) |
207R00000X Internal Medicine (Licence: WI 22101) | |
Enumeration Date | 2007-03-08 |
Last Update Date | 2023-05-02 |