NPI | 1083956031 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.207550) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2016-0175) |
Enumeration Date | 2013-03-17 |
Last Update Date | 2019-08-26 |