NPI | 1053715300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C185212) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125065444) |
Enumeration Date | 2014-10-15 |
Last Update Date | 2023-08-15 |