NPI | 1710514849 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A196153) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 323239) |
Enumeration Date | 2020-03-26 |
Last Update Date | 2024-10-25 |