NPI | 1003878752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 113515) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35067778R) |
207R00000X Internal Medicine (Licence: CA C51583) | |
207Q00000X Family Medicine (Licence: NV 11315) | |
207R00000X Internal Medicine (Licence: WA MD60547149) | |
Enumeration Date | 2006-04-06 |
Last Update Date | 2022-08-11 |