NPI | 1972598639 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A77102) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 235957) |
Enumeration Date | 2005-09-19 |
Last Update Date | 2021-12-15 |