NPI | 1003135328 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 58191) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 106796) |
Enumeration Date | 2010-05-26 |
Last Update Date | 2024-06-13 |