NPI | 1912393281 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A177794) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10312300) |
207R00000X Internal Medicine (Licence: OH 36.136286) | |
Enumeration Date | 2015-04-13 |
Last Update Date | 2022-08-11 |