NPI | 1093205197 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T0694) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10063736) |
208D00000X General Practice (Licence: TX T0694) | |
Enumeration Date | 2018-05-14 |
Last Update Date | 2022-01-25 |