NPI | 1710951694 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 22999) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 128398) |
207R00000X Internal Medicine (Licence: NY 162479) | |
207R00000X Internal Medicine (Licence: IL 036.158387) | |
Enumeration Date | 2006-02-15 |
Last Update Date | 2023-01-19 |