NPI | 1902044464 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 265040) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 003510) |
Enumeration Date | 2009-01-21 |
Last Update Date | 2015-12-13 |