NPI | 1801328604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A161657) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 323884) |
Enumeration Date | 2017-03-30 |
Last Update Date | 2024-08-12 |