NPI | 1902081797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 265426) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D70773) |
Enumeration Date | 2007-12-31 |
Last Update Date | 2019-04-25 |