NPI | 1043457005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A137266) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD29410) |
Enumeration Date | 2009-01-13 |
Last Update Date | 2022-12-14 |