| NPI | 1790749422 |
|---|---|
| Other Name | TY JUSTIN GLUCKMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD26695) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D0058894) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2012-12-18 |