NPI | 1851387971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 139718) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 021366) |
207R00000X Internal Medicine (Licence: AL 20577) | |
Enumeration Date | 2005-09-23 |
Last Update Date | 2020-05-27 |