NPI | 1720802523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4351054785) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY P130909) |
Enumeration Date | 2024-11-09 |
Last Update Date | 2025-06-04 |