NPI | 1053540203 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301109111) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP01635) |
Enumeration Date | 2009-07-09 |
Last Update Date | 2018-06-15 |