NPI | 1023163128 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD32366) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D57310) |
Enumeration Date | 2007-01-25 |
Last Update Date | 2021-06-27 |