NPI | 1972584274 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 18471) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 205467) |
Enumeration Date | 2005-11-14 |
Last Update Date | 2019-04-04 |