NPI | 1912166679 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D69581) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 248289) |
Enumeration Date | 2008-06-06 |
Last Update Date | 2013-02-04 |