NPI | 1770530065 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 232725) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA78631) |
207R00000X Internal Medicine (Licence: CA A86251) | |
Enumeration Date | 2006-05-30 |
Last Update Date | 2012-01-03 |