NPI | 1861574279 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME148336) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA58280) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2025-02-28 |