NPI | 1033268982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD26157) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60036057) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2023-07-31 |