NPI | 1013011303 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 321454) |
Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: LA 321454) |
207RX0202X Internal Medicine Medical Oncology (Licence: LA 321454) | |
208D00000X General Practice (Licence: MS 12640) | |
Enumeration Date | 2006-09-08 |
Last Update Date | 2023-05-03 |