NPI | 1891706768 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 058876) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 152906) |
Enumeration Date | 2006-08-10 |
Last Update Date | 2009-09-01 |