NPI | 1043870009 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61331507) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019018426) |
Enumeration Date | 2019-06-20 |
Last Update Date | 2022-09-10 |