NPI | 1104182641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 23848) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-13941) |
207R00000X Internal Medicine (Licence: TN 52692) | |
Enumeration Date | 2012-04-10 |
Last Update Date | 2021-02-22 |