NPI | 1023371069 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 074714) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2015-01514) |
Enumeration Date | 2012-06-22 |
Last Update Date | 2019-05-09 |