NPI | 1912587510 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 331745) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME169539) |
207R00000X Internal Medicine (Licence: NJ 25MA12314900) | |
207R00000X Internal Medicine (Licence: GA 101585) | |
Enumeration Date | 2021-04-09 |
Last Update Date | 2024-09-03 |