NPI | 1013983196 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2023-1656) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 33041) |
207R00000X Internal Medicine (Licence: IL 036164434) | |
Enumeration Date | 2006-02-27 |
Last Update Date | 2024-04-26 |