NPI | 1043470750 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 082320) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 150024) |
Enumeration Date | 2008-06-16 |
Last Update Date | 2022-04-12 |