NPI | 1750399374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 230883) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY NY222003) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2021-02-18 |