NPI | 1003850611 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301057790) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 40857) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2019-12-19 |