NPI | 1700972155 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 059795) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 232545) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2021-02-26 |